Patient is being seen for [select name="variable_1" value="|Right|Left|Bilateral"]
[checkbox name="variable_1" value="eye redness|eye discharge|eye pain|eye injury|crusting"]
[checkbox name="variable_5" value="Discharge purulent|Discharge white"]
Symptoms lasting x [select name="variable_2" value="1|2|3|4|5|6|7"] Days
[checklist name="variable_2" value="Visual changes|photophopiba|eye pruritus|facial rash|runny nose or recent colds|eye swelling|tearing|"]
[text name="variable_1" default=""]
[checklist name="variable_3" value=" Glasess|Contacts|chronic eye disorder"]
[checkbox name="variable_4" value="OTC eye drops|abx eye drops|Allergy eye drops"]
Constitutional: He appears well-developed and well-nourished. He is active, cooperative and in no acute distress.
HEENT: Mouth/Throat: Mucous membranes are moist. No tonsillar exudate. Oropharynx is clear. Pharynx is normal. Nares patent. No cervical lymphadenopathy
Eyes: Conjunctiva red bilaterally. Diffuse redness (hyperemia) of bulbar and palpebral conjunctiva. Scant watery discharge bilaterally, +pruritis. Pupils are equal, round, and reactive to light. No edema of eyelids, no crusting bilaterally EOMs normal bilaterally. 20/20 near and distant vision in both eyes. Red reflex present bilaterally. No strabismus, no nystagmus. Fundoscopic exam normal, vessels intact, optic disc with clear margins.
Neck: Neck supple. No rigidity.
Cardiovascular: Regular rhythm, S1 normal and S2 normal.
Pulmonary/Chest: Effort normal and breath sounds normal. There is normal air entry. No respiratory distress, no wheezes.
Abdominal: Abdomen soft, non-tender, non-distended. Bowel sounds present in all 4 quadrants. There is no hepatosplenomegaly. There is no guarding.
Neurological: He is alert and oriented x3. CN II-XII grossly intact.
Skin: Skin is warm. Capillary refill takes less than 3 seconds. No petechiae or rash noted. He is not diaphoretic. No jaundice
There are 8 form elements.
Result - Copy and paste this output: